My op seems to have gone well. I am now a little less cartilaginous, and very glad of it.

I had an early start this morning (I'd set my alarm for 2am) - then, after completing my various preparations, I set off at 4, to catch the coach into London. I like getting up early once in a while, and enjoyed watching the sun rise over London as we sped along the flyover to Baker Street.

I arrived at Charing Cross Hospital at half past 7; then, after the usual set of questions relating to my medical history, I was sent straight up to the anaesthetist's room, for an unexpectedly early surgery. By mid-morning, I'd awoken in the recovery room, feeling more groggy than I'd felt the previous two times, but in no real pain. For four hours, I drifted in and out of much-needed sleep while I waited for a bed to become free in one of the wards.

My throat is a little sore, but I've eaten at last. I've also been kept entertained by some lovely guests. The nurses tell me that I should avoid talking over the next few days. This is appropriate, because I currently have no voice. Either this will remedy itself in time, or I shall dissolve into sea foam. I consider the latter possibility to be highly unlikely, but I suppose they have to cover their backs on the consent forms, just in case ;)

Although my throat seems swollen, I can feel that there is no longer a prominence where there once was one. Looking at myself in the mirror, there's something of the post-surgical glow I had three months ago. I'm happy.
It's looking to me as though the world might develop into a suitably favourable bivalve.

Having decided to explore the possibilities of teaching abroad (specifically, in Japan), I've signed up to a weekend “Introduction to TEFL” course that Oxford's Continuing Education people are offering. I won't pick up a TEFL qualification from it, but it ought to provide a good foundation for whatever course I decide to take afterwards...

...which might take some thought. CELTA is a little pricey and cumbersome, particularly when considering that I'd have to give up my current job to take such a course. I'd rather wait until I've actually secured a job overseas before handing in my resignation here. I've picked up a brochure from i-to-i (, which offers a weekend course coupled with online training – I'm a pretty good self-starter generally, so the reduced classroom time shouldn't be a problem, particularly if I can sit in on some lessons at one of the language schools in Oxford on days off work. But then, while i-to-i TEFL courses are ODLQC-accredited and their qualifications are 'internationally recognized', I get the impression that they might not have anywhere near the universal recognition that CELTA's do. So I want to establish that i-to-i take their courses seriously and are taken seriously in turn - if not, I'll just have to budget for a CELTA. Any thoughts or advice will be gratefully received.

In the meantime, I'm back in hospital again on Tuesday, for my chondrolaryngoplasty. I'm not quite as nervous as I was last time, but then, this is relatively minor surgery. [Persistent Inner Voice: “But it *does* involve people carving at your *throat* with *knives*.”] And it's apparently even less likely to go wrong than GRS was. [PIV: “Ooh, here's an idea – why don't we watch Sweeney Todd tonight?”] And I'm looking forward to overcoming the compulsion to cover my neck all the time. *gags PIV with pashmina*

So... if any of you are at a loose end near Hammersmith at late afternoon on 1st September, you're very much welcome to visit me at the Riverside Wing of Charing Cross Hospital :)
It's good to be mobile again.

I've started cycling once more, so yesterday, I took a trip to the chalk downs south of Uffington, to see Dragon Hill and the White Horse. I'd plotted what turned out to be a picturesque route from Oxford to Uffington village, allowing me ample opportunity to enjoy the rural Cotswold countryside on the way. Oh, the old black and white signposts! And the duckponds with maritime accessories! And, and, and there was a weasel! Wheeee!

From Uffington itself, the terrain became a little too hilly to subject my poor fold-up city bicycle to, so I got off and walked. I'd been terrified that the weather would turn nasty, and couldn't quite believe just how beautiful it was. Once I'd succeeded in dragging my bike to the car park near the top of the downs, I could see for miles across perfect countryside and, um, Witney power plant. It was difficult to get a good view of the White Horse – from different positions, it was possible to marvel at either the head or the body, but never both – still, I'd already been told that the horse only really resolves well from the air, so I wasn't disappointed.

I ought have had the sense to stay off my bike on the way down, but I was getting tired and told myself that I could use my brakes to keep myself at a steady speed. I'd never tried cycling down such a steep slope before, so it came as a surprise that the insistent application of both brakes only produced of a noise like the moans of a dying whale and a smell suggesting rapid combustion of that unfortunate cetacean's fatty deposits. After narrowly avoiding a head-on collision with a flock of sheep, I sped, screaming in a subdued fashion, back towards the village. I estimate that a whole two miles went by without my feeling the compulsion to pedal.

I really started to flag on the way back – my miles for that day totalled just over fifty by foot and bicycle, and I haven't attempted anywhere near that much for some time – well, certainly not since my op. By the time I pulled up at the bike-racks at home, my limbs, back and bum ached reproachfully – my legs nearly collapsed under me when I alighted from the bike. I *really* need to get properly fit again.

Also, in the conflict between sweat and sunblock, sweat won. I now look permanently embarrassed.

Oh, but it was *fun*! I love my little self-propelled excursions in the summer months. I must decide where to go next.
I was back in London this week, being pampered by the personal shopper at Debenhams (new clothes, woo!), meeting wonderful people at TransLondon, holding penguin parties with [ profile] ktroo85 and her mother, and having a post-surgical check-up at Charing Cross. Mr Thomas seemed very pleased with the results of my operation, and, with the application of a little silver nitrate to pacify the granulation tissue I've developed, declared that we shouldn't need to schedule any more such appointments - I'll be *fine*. This is good to know, as I'm hoping to return to work properly next week.

I will, however, be returning to Charing Cross hospital for a simple tracheal shave operation (to reduce my Adam's apple) on 1st September. I'm amazed - I'd requested a referral in the expectation that the PCT wouldn't dream of funding the procedure, after all their recent reluctance even to fund GRS. As it happens, there was never any argument made by them - perhaps because they're wary of me by now, perhaps because it will hardly cost them anything... but I hope it's another sign that they are working on changing their attitude towards funding.
Thanks to the excellent [personal profile] thalassius, who has let me borrow his spare laptop, I'm now able to connect to the Internet from home again. I'm still not sure why my own computer continues to treat this wireless network with such disdain; certainly, it doesn't have any objection to other networks I access when out and about - and it's unfortunate that I haven't been out and about as much as I'd like to be.

My first attempt to return to work didn't turn out *spectacularly* well (I didn't last the morning), but I'm going to make another trial attempt tomorrow. I'm getting increasingly impatient with this whole being-stuck-at home-by-myself-all-the-time thing (although I did have lots of fun meeting up with people this week), and my body seems unwilling to heal much beyond the stage I'd reached at the time of my last journal entry. Still, I'm much more active than I was a month ago, and perhaps I just need to be more sensible in recognizing my limitations.

That said, I'm very much appreciating being *here*. I may have a lot to sort out, but, well, some rather fundamental issues have been dealt with, and I'm looking forward to starting a new chapter in my life. However much I might feel trapped at home for now, I don't feel trapped in my own body any more. Cliche, perhaps, but it works for me.


Jun. 17th, 2009 07:16 am
- briefly.

My computer and phone are now conspiring to silence me. My computer has decided that the wireless network at home is now password-protected (it really isn't), and won't let me in until I've guessed whatever nonsensical set of characters its fevered imagination has dreamt up. My phone resists all attempts to allow me to top it up - apparently, the 7p that remains on there already exceeds my maximum calling credit. Until I can sort these things out properly, I regret that my posts are likely to be few and hastily written.....

Oh, yes, that's right... I must be quick....

I'm still recovery in a fairly promising fashion, as far as I can tell. Blood is tiresome now.

I'm learning that a stubborn belief in my capacity to do something is not always sufficient. Sometimes, just one little bag of shopping may be too much.

I seem to be doing OULES., and this may be fine. This term, all I have to do is lie under a tree for a while and then waddle on and sing four lines as a polar bear. I must attempt to locate the elusive polar bear costume.

I sent my latest gender-dysphoria-policy-review-critique letter off in time. My decision to stay up until nearly 4am one night last week to get it finished, when I'm finding myself in need of more rest than usual, may be why I spent almost all of the following forty-eight hours asleep.

There are many people with whom I must get in contact. I'm sorry. I'll try to get this internet thing sorted out as soon as possible....
I estimate that, with occasional breaks to eat, take painkillers, dilate, wash, and be scared of the BNP, I've slept for 17 hours of the last 24. My body is apparently trying to remind me that, although my recovery at last seems to be going well, I still need to rest up. I still feel exhausted.

This is a little worrying, because *I have work to do*.

Following recent pressure that has been placed on Oxfordshire PCT by, um, concerned stakeholders, the South Central Priorities Support Unit has issued a draft paper for consultation regarding the new gender dysphoria policy to be adopted on a regional level. I've received a copy of this paper, and taken time to digest its content. While much of what it says seems quite positive, particularly early on (there's an acknowledgement that care needs to be patient-centred and that different care pathways will be appropriate for individual patients; there's even consideration of the risks of non-treatment, including suicide rates), by the end of the document, the two potential policies for consideration are virtually the same as those suggested in 2006:

- The first resembles the one adopted by Oxfordshire three years ago, stating that core and non-core surgery will only be funded in exceptional circumstances... but this time, it includes the qualifier that appropriate exceptional circumstances will need to be identified. As though they ever came *close* to doing so before. Even if it looks unlikely that they'd be able to justify adopting this policy after everything that's happened, it's worrying that it's made the draft again, especially as it would not just be Oxfordshire, but the whole of NHS South Central, that would be affected by it.

- The second possible policy is virtually identical to that previously adopted by all of the other South Central PCTs -.that core surgery (i.e. genital surgery for trans women, and genital surgery and top surgery for trans men) may be funded for patients fulfilling the WPATH (Harry Benjamin) suitabiliy criteria, if they have been referred by two NHS specialist clinicians. Non-core procedures may only be funded in exceptional circumstances. Non-core procedures appear to include genital hair removal, which is for many people a necessary precursor to genital surgery.

The big pity is that, earlier on, *three* possible policies are identified - the other one accepts that the distinction between core and non-core procedures is fairly arbitrary and will differ between patients, so can be decided on an individual basis by specialist clinicians. In spite of the fact that so much of the cited evidence emphasizes the importance of appreciation of the needs of individual patients, and selection by qualified specialists, this option has mysteriously dropped out by the end of the document. This is presumably owing to the issue of limited NHS resources, to which the draft makes frequent reference. However, I believe that the one-size-fits-all approach operates a false economy in the long term.

I'm now trying to compose a letter to the Priorities Support Group. The deadline for comment is scarily close - Friday - so I really ought to get it finished by Wednesday. The timing is unfortunate, considering how sleepy and lethargic I am at present, and considering that two of the other three who went with me to talk to the PCT representatives are now in hospital recovering from surgery. I'm hoping to include a few references they missed in their literature review; a criticism of another reference cited; a query as to why exactly the third policy option has been dropped and the first policy option has been retained in spite of Catch-22 implications;... and possibly also something about the merits of outsourcing work to private clinicians. I'll try to keep it concise, and with the limitations of time I'm faced with, this may not be difficult.

I'd like to be able to get in touch with as many people who might conceivably be affected directly by this policy review as possible. That means any gender dysphoric person currently progressing through the system (or failed by it) in Oxfordshire, Buckinghamshire, Berkshire, Hampshire and the Isle of Wight (including Milton Keynes, Southampton and Portsmouth, even though they have separate PCTs). I'd originally considered getting signatures from as many *allies* as possible, but as I can already reference the petition, I thought I'd limit myself to people from whom they might receive a potential direct threat of litigation.

Please feel free to forward anyone potentially affected by this to me - the more people we can bring together over this, the better.


Jun. 2nd, 2009 09:37 pm
In accordance with the wishes of a few friends who are presumably sick of hearing about blood and genitals, this post is mostly free from TMI.

I'm getting better. At least, I'm in much less pain and finding it easier to move around and to get comfortable. I can lie on my side now to sleep; I can sit for short periods; I can walk without it hurting - as long as I don't try to do too much or strain myself, I'm fine. Actually, I'm very happy: I feel as though I still haven't shaken off the post-operative glow. I've been wandering around grinning too much, and enjoying the sunlight. I'd like to be able to enjoy the sunlight for longer every day, but my body has been strict in telling me when enough is enough. I hate to waste the summer, but I'm aware I must allow myself chance to recover - anyway, I'd only be spending my time selling music in a dingy shop if I hadn't had surgery - I'm probably catching more of the good weather this way.

I even managed to take a trip back into London yesterday, so that the surgeons could check up on me regarding the - um, the problem I've mentioned in other recent posts. It was all rather last-minute - Lisa, the Clinical Nurse Specialist, had arrived back from a week's holiday that day, so first thing in the morning, I took the opportunity to contact her directly about the... issue, rather than going via the clinic itself. I explained the situation to her, with a mention that my nurse in Oxford has expressed concern; Lisa seemed a little alarmed, and asked whether I might be able to get over to see the surgeons *by 3pm that day*. I was slightly taken aback, but glad that they were taking me seriously, so I said I'd try. I was also a little scared - Lisa is the most experienced person I'd talked to about this, and if she was worried enough to clear a same-day appointment for me, well....

It was only when I put the phone down that I realised I'd probably need to take the bus into London myself, without the luxury of my brother acting as courier this time. For a moment, I wondered about sending a plea to possible drivers over the Internet... but I suspected that nobody would be around and able to reply in time, and I didn't want to alarm everyone by mentioning my requirement to go back to the hospital, at least, not until I'd worked out how serious this was. So. I decided to take the bus into town, and then the coach to London, and then the tube to Hammersmith. The actual amount of walking involved would be minimal, and I could probably stand on the bus and on the tube, and recline on the cou-, um, coach.

It was uncomfortable and tiring, but I felt accomplished by the end of the journey - it feels *good* to be so mobile. Still, I was glad when it was over. Lisa had told me to pack various essentials, so I was half expecting to be readmitted to hospital and to have a break from travelling at least for the rest of the day. In fact, my appointment with Lisa and the surgeon resulted in my being sent straight home. When I showed them the problem, they ummed and aahed a little, but decided... and at this point I'm afraid I'm going to have to move into the realms of...

So, yes, I then had to make my way back home again. By the time I reached my room, the collected journeys had left me exhausted, and very sore.

I'd been expecting to spend the whole of today in bed, recovering from the previous day's exertions - but when I saw how beautiful it was outside, I couldn't resist but to take a bus into Oxford and have a walk around. I hobbled along Cornmarket Street, wishing I could do some shopping (trying on clothes would not be a good idea at present). I drifted into Worcester College and did my old favourite walk around the lake. It's been a very long time since I last visited my old college, and I forget how pretty it is. I was feeling pleasantly wistful by the time I found myself back in the main quad - so many memories, and such a rekindling of desire to find my way into academia in the future....

This may have some connection with the dreams I've been having lately. For some reason, since arriving home from hospital, I've had at least two anxiety dreams to do with academic work. Last week, I was falling behind in studying for my A-Levels, playing truant to spend time with a branch of my family I'd only just become aware of (they were travellers, with a brightly-colored horse-drawn wagon); and I was considering dropping out of school. Last night, I hadn't been putting the work in on my degree, and my coursework essays were severely unbalanced - I'd done too many on animals, and hadn't a clue what to write about plants (I remembered something about a magical beanstalk, but I was fairly sure that didn't actually exist); the Pillars of Academia turned their stone faces towards me in contempt.

I'm itching more and more to *get down and study something*; I just - still - haven't worked out what it's to be, yet.

For now, I really ought to appreciate my own sense of gladness :D
Oops - I haven't made very good with my promise to be more Internet-active on arriving home. Sorry.

I've been spectacularly sleepy. The journey home on Sunday meant exerting myself more than I can maintain at present, and every little activity tires me out more than it ought to. As I'm now able to get comfortable enough to go to sleep, my body has opted to remind me of how exhausted I am in the hope that I'll take the hint and get some rest. I seem to have spent most of my time dozing.

Cut for blood and TMI )
So, yes, I'm taking things easy at the moment. I hope to be in a better position to see people soon, though :)


May. 24th, 2009 09:38 am
I suppose a post with a title like that could go either way, really.

As it happens, I've stayed on course for my discharge from hospital this afternoon. My brother will be picking me up by car, and we ought to arrive back in Oxford before 5pm. I'm not relishing the idea of a long car journey at the moment, but I'm sure we can make stops if need be, and the pleasure of being able to go outside for the first time in a week ought to make things easier.

Actually, I'm finding it much easier to get comfortable now, and managed a decent amount of sleep last night. Dilating gets less painful every time, and my fourth session (this morning) was really very bearable. I've worked out that it hurts less if I breathe heavily, take frequent sips of ice-cold water, and listen to soundtracks from musicals for the duration. But my body also seems to have worked out what's going on now, and is behaving much more charitably towards me.

I'm actually going to miss the hospital. It's *lovely* here - I'll regret having to give up my adjustable bed, all the tasty veggie curries, and the company of the other patients and friendly nurses. In spite of the pain and discomfort, I've spent a happy seven days here.

Thank you so much to all of you who have come to visit me - it's meant so much to me to see you all, and to be able to spend some of this time with you. Thank you for the cards and presents, which have kept me occupied during periods of inactivity and reassured during periods of pain. Thank you to everyone who has sent good wishes - I'm so lucky to know so many lovely people. Perhaps the more reliable Internet access at home will give me the opportunity to answer the backlog of joyous comments.

So much love :)


May. 23rd, 2009 11:38 am
Ow. Nice ow, but ow.

Did you *read* the title of this post?? )
Oh, but then I was finally allowed to have a shower. It felt *so* good - I'm clean again!

...and in just over an hour's time, I repeat the last few steps.

Unfortunately, this may mean it'll be a little after 2pm that I'll be ready to see visitors today... although you're welcome to eat the food and play with the various soft toys by my bed until I'm out of the shower.
I've been making surprising progress with my recovery, especially considering the unfortunate setback I experienced a few days ago. I've just seen the Clinical Nurse Specialist, who has suggested that I can have the pack and catheter out tomorrow (ouch, but finally - chance for a shower!) and be discharged on SUNDAY! :D :D :D
I can walk! I can walk - it's amazing, and makes me feel so accomplished. I've walked to the toilet and back a few times today, and even made an exciting voyage to the reception desk of the Riverside Wing to see my lovely flowers! I can walk, (and it hurts and I'm so weak and I'm left gasping at the end of each little excursion, but...) I can walk!

The surgeon came and checked my wound this morning, and told me that it's all looking fine now - the second op really has sorted everything out, and I'm back on course with my recovery. I'm not hurting much now, and they've taken the morphine drip away (which has really helped with mobility). If all goes well, my recovery now ought to be fairly uneventful until they remove the pack on Monday.

More joyous visitors today, too. I really am being terribly spoilt at the moment :)


May. 21st, 2009 06:49 am
For the first time in over a week, I've just had a good night's sleep.

As far as I can tell, the second op has had the desired effect - I haven't yet seen Dr Bellringer, who was apparently due to talk to me about it yesterday, but the pain has faded enough to be easily manageable. Before yesterday's surgery, I was at the stage of spending the hours hitting my maximum morphine dosage and then watching the clock intently to see when I could have some more. Since the latest op, I haven't been using much analgesic at all - I haven't had a single shot in the last ten hours. This is joyous, not least because I've come to the conclusion that I really don't like morphine. I don't find its effects on me especially appealing, and I'm really beginning to dislike not having the use of my left hand. I probably ought to have mentioned that I'm left-handed before they put the drip in, but from what I understand, they have to set the drip up on the left of the bed as standard. It *has* given me the opportunity to practice various activities with my bad hand only - having fully assembled a woodcraft construction kit squirrel (thank you, princessdanae!), I'm feeling rather pleased with myself.

In spite of the pain (the removal of the surgical drains on Tuesday was the single most agonising experience of my life), I've spent my time post-op feeling better than I can remember feeling, and very happy. I feel so *peaceful*. I woke up bathed in light this morning (I'm fortunate in having been given the bed nearest the window in my room), and I just lay here enjoying the sensation of warmth falling onto my body.

As far as I can tell, this room contains six beds altogether (I haven't really been able to get up and check!). When I was wheeled in here after the operation, all of those beds were occupied by trans women, most of whom had had their surgery the week before and were almost ready to be discharged. We were a diverse group of characters, and we got on well together. In some ways, it was strangely like being at boarding school. Those who were relearning how to walk would visit those of us who could scarcely move, and explain in graphic detail what to expect in the coming days. Social graces were turned on their head: to compare wounds was a polite greeting (well, it was helpful to see that you weren't the only person whose bruises had bruises). Truly is it said that the collective noun for a group of trans women is a TMI. I exchanged mobile numbers with two of the others before they left; there are now only two of us remaining, and the other beds are occupied by patients with a diversity of conditions.

The nurses here are very friendly; and the food is surprisingly good, with easily enough vegetarian options on the menu to keep me going for the next week. It's looking like they'll leave it until Monday to take the pack out of my vagina; my discharge from hospital is likely to be next Wednesday. This all depends on what happened during the second op. For somebody who had never been admitted to hospital before Sunday, I feel as though I've been thrown in at the deep end - two ops in three days, with the chance to sample the work of both surgeons, Mr Thomas and Mr Bellringer. It's a strange sort of holiday.

Thank you to everybody who has come to visit me - it's meant *so* much to have my friends around me for this. *Much, much love to all of you*.

Oh, yes - I ought to rest a little now; I keep forgetting how weak I am at present. I'll update again as soon as I can next get the WiFi working....
Just a quick update to let people know that my next operation is expected to be at 1pm today, and is supposedly vry quick. They also mentioned that this haemtoma is the only reason that I'm in so much pain - it will have gone away when I wake up, so I oughht to be visitable this afternoon :)

Love xxx
I've managed to get this WiFi working on on here again. I don't really have much to add to princessdanae's post on sallyop, the only thing being thst they've just given me an early breakfast and told me my next op will be due for some time in the afternoon. I've been in a quite a bit of pain (sorry to those lovely people who came to see me yesterday amd ended up having to look aftr me - I now have a Darwin to cuddle, and many wondrous books and activities to take my mind off things) but it's not hurt as much so far today - I'm quite scared thoufgh (although, as shiny people point out, I'm in exactly the right place to be able to deal with this. Mainly, I'm happy that *it's gone*! Just after this other op, I mmight actually be in a better position to see visitors (I was wide awake for some time after I regaining consciousness from my first one.


May. 18th, 2009 08:28 pm
I'm safe, calm, and happy.

(sallyalice at Dreamwidth)